Concluded Case

Pituitary Macroadenoma

Todays 1st OPD CASE. 22yr,M,No known comorbidities, Presented with rt hemicranial head ache since one year,aggravation of already existing head ache 2 weeks,blurring of vision with almost continuous head ache 2 days.He has been getting recurrent episodes of rt hemicranial head ache for one year,throbbing in character,4-5/ month,each episode for 8 to 24 hrs with photophobia and phonophobia. Journey and hunger used to precipitate the head ache.Since 2weeks he has been getting very frequent head ache ,quality of head ache is the same as before. Since 2 days he has rt hemicranial almost continuous head ache with blurring of vision. On exam vitals stable. Normal optic fundi.Rt field deficits with out any long tract signs. AFTER SEEING THE MRII brain requested hormonal work up. What abnormality in the MRI brain?

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Concluded answer

Thanks for the answers. MRI brain with contrast : Expansion sellar lesion with suprasellarextrnsion, compressing the posterior pituitary and optic chiasma with gr 1 invasion of bilateral cavernous sinuses .The Rt anterosuperior part of the lesion is displacing the internal segment of the rt optic nerve and compressing the gyrus rectus.Lesion shows diffuse heterogeneous enhancement. FEATURES SUGGRSTIVE OF PITUITARY MACROADENOMA. ALL NECESSARY HORMONAL WORK UP NORMAL. Posted for elective surgery by the Neurosurgeon.

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Thanks for the answers. MRI brain with contrast : Expansion sellar lesion with suprasellarextrnsion, compressing the posterior pituitary and optic chiasma with gr 1 invasion of bilateral cavernous sinuses .The Rt anterosuperior part of the lesion is displacing the internal segment of the rt optic nerve and compressing the gyrus rectus.Lesion shows diffuse heterogeneous enhancement. FEATURES SUGGRSTIVE OF PITUITARY MACROADENOMA. ALL NECESSARY HORMONAL WORK UP NORMAL. Posted for elective surgery by the Neurosurgeon.

Supraseller mass? Pituitary Adenoma with associated cluster headache

Lacunar infarct in rt occipital Midline shift rt Opinion of neurologist

Thank you doctor
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Pituitary harmonal profile.. If prolactinoma start on cabgolin otherwise a good case for endoscopic surgery

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